| NPI | 1669426961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101255880) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017000577) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-01-13 |